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					        Republic of The Gambia
  Department of State for Health
               & Social Welfare



   THE GAMBIA
MENTAL HEALTH
STRATEGIC PLAN
      2 0 0 7 -2 0 1 2


                    March 2007
                The Gambia Mental Health Strategic Plan 2007-2012
                                               Republic of the Gambia




                        Republic of The Gambia

              Department of State for Health




            THE GAMBIA
          MENTAL HEALTH
          STRATEGIC PLAN
             2 0 0 7 -2 0 1 2

Directorate/Division:

Address

Tel.
Fax.
Email.

March 2007



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                The Gambia Mental Health Strategic Plan 2007-2012
                                                      Republic of the Gambia



                             FOREWORD
It is estimated that approximately 27,000 people in the Gambia are suffering
from a severe mental and/or substance abuse disorder and that a further 91,000
Gambians have a mild disorder still requiring treatment (World health Survey,
2004) .A local prevalence study in the Gambia, puts prevalence rates higher (at
20%) and leads to estimates of approximately 180,000 people suffering from a
mental or substance abuse disorder. Providing effective treatment and support
to all these people is challenging, given the scarce health resources in the Gambia
and an overall situation of poverty in the country, where 34% of the population
live below the poverty line and 18% of the population are extremely poor.
However, consultation with many different experts, health professions and key
individuals from different government sectors has highlighted the great need,
willingness and strategies required to strengthen the overall mental health
system in order to provide effective treatment and care to those in need as well as
to promote the mental health of all Gambians.          In fact it is through this
consultation and the work of the drafting committee that enabled the Gambia to
develop its mental health policy as well as the current mental health strategic
plan. Both these documents should be read side-by side, with the policy
providing the key objectives and the overall directions and the strategic plan
document outlining the concrete strategies and activities that will be
implemented to implement the policy directions.

Thanks also go to WHO-Gambia, WHO-AFRO and WHO Geneva offices, who
provided financial and technical assistance for its development. A list of all those
who contributed to the development of this plan are attached as an annex 1.


Dr Tamsir Mbowe,
Secretary of State for Health and Social Welfare.

SIGNATURE



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                     The Gambia Mental Health Strategic Plan 2007-2012
                                                                Republic of the Gambia



                       TABLE OF CONTENTS

Foreword                                                                                 iii

List of Abbreviations                                                                    1

Glossary                                                                                 2


FRAMEWORK FOR MENTAL HEALTH STRATEGIC                                                    3
PLAN
        1. Objectives                                                                    3
        2. Strategies                                                                    4
        3. Strategies and related Activities                                             5
         ■ Strategy 1: To strengthen the national mental health coordinating             5
unit at the Department of State for Health.
        ■ Strategy 2: To mobilize resources for mental health interventions              6
  with a view to providing quality services.
      ■ Strategy 3: To review the existing mental health legislation of The              7
Gambia in line with the international human rights standards
        ■ Strategy 4: To raise awareness and reduce negative perceptions about           8
those suffering from mental and substance abuse disorders through the use of
advocacy and Information, Education and Communication (IEC) strategies
        ■ Strategy 5: To improve the availability, distribution and use of cost-         9
effective psychotropic medicines
       ■ Strategy 6: To support the strengthening of the health management               10
information system to adequately address mental health issues
        ■ Strategy 7: To strengthen community involvement and participation              11
in mental health care delivery
         ■ Strategy 8: To create 3 in-patient mental health units and outpatient         12
clinics integrated in the general hospitals
      ■ Strategy 9: To improve treatment and human rights conditions in the              14
Campama psychiatric unit pending its closure
       ■ Strategy 10: To recruit and train a sufficient number of health                 15
workers at the specialized, community and primary health care levels
        ■ Strategy 11: To train and support traditional healers in mental health         17
        ■ Strategy 12: To monitor and evaluate the mental heath policy & plan            18




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                     The Gambia Mental Health Strategic Plan 2007-2012
                                                                Republic of the Gambia

PLANNING TABLES                                                                          19
         ■ Strategy 1: To strengthen the national mental health coordinating             20
unit at the Department of State for Health.
        ■ Strategy 2: To mobilize resources for mental health interventions              21
  with a view to providing quality services.
      ■ Strategy 3: To review the existing mental health legislation of The              22
Gambia in line with the international human rights standards
        ■ Strategy 4: To raise awareness and reduce negative perceptions about           23
those suffering from mental and substance abuse disorders through the use of
advocacy and Information, Education and Communication (IEC) strategies
        ■ Strategy 5: To improve the availability, distribution and use of cost-         24
effective psychotropic medicines
       ■ Strategy 6: To support the strengthening of the health management               25
information system to adequately address mental health issues
        ■ Strategy 7: To strengthen community involvement and participation              26
in mental health care delivery
         ■ Strategy 8: To create 3 in-patient mental health units and outpatient         27
clinics integrated in the general hospitals
      ■ Strategy 9: To improve treatment and human rights conditions in the              29
Campama psychiatric unit pending its closure
       ■ Strategy 10: To recruit and train a sufficient number of health                 30
workers at the specialized, community and primary health care levels
        ■ Strategy 11: To train and support traditional healers in mental health         32
        ■ Strategy 12: To monitor and evaluate the mental heath policy & plan            33

SUMMARY TABLE                                                                            34
       Table: Summary Cost of Implementing the Mental Health Strategic                   34
Plan 2007-2012

SUMMARY GRAPH                                                                            35
       Graph: Summary Cost of Implementing the Mental Health Strategic                   35
Plan 2007-2012

References                                                                               36

ANNEXES                                                                                  37
        Annex 1: Acknowledgements                                                        38




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         The Gambia Mental Health Strategic Plan 2007-2012
                                            Republic of the Gambia


List of Abbreviations

CU         Coordinating Unit
DMO        District Medical Officer
DOSH       Department of State for Health
HW         Health Workers
HWPCL      Health Workers at Primary and Community Levels
HMIS       Health Management Information System.
NC         National Coordinator
PWMD       People With Mental Disorders
W.H.O      World Health Organization




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                  The Gambia Mental Health Strategic Plan 2007-2012
                                                         Republic of the Gambia



Glossary

Mental Health Plan: these are a coordinated set of strategies and activities, to
implement the policy and improve mental health of the population, and are defined by a
timeframe, targets, indicators and a budget

Mental Health: A state of emotional and psychological well-being in which an
individual is able to use his or her cognitive and emotional capabilities, function in
society, and meet the ordinary demands of everyday life.

Mental Disorder: The existence of a clinically recognizable set of symptoms or
behavior associated in most cases with distress and with interference with personal
functions. Social deviance or conflict alone, without personal dysfunction, should not be
included in mental disorder as defined here”




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia




       FRAMEWORK FOR MENTAL HEALTH
             STRATEGIC PLAN

1. Objectives
i.      To provide equitable access to quality mental health care to all people in the
        Gambia with mental and substance use disorders including vulnerable populations
        (i.e., children, women, the aged, migrants and refugees among others).

ii.     To promote and protect the human rights of people with mental and substance use
        disorders.

iii.    To change negative perceptions of the population regarding people with mental
        disorders and substance abuse through the sensitisation of communities to mental
        health issues.

iv.     To provide mental health and substance abuse services which are integrated into
        the entire health care system and widely available through secondary, primary,
        and community based services

v.      To reduce institutionalisation of people with mental and substance abuse
        disorders.

vi.     To decentralize authority, resources and services for mental health care, allowing
        for more participatory decision at the primary health care and community levels,
        including consumers and family members.




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                 The Gambia Mental Health Strategic Plan 2007-2012
                                                        Republic of the Gambia


2. Strategies
■ Strategy 1: To strengthen the national mental health coordinating unit at the
   Department of State for Health

■ Strategy 2: To mobilise resources for mental health interventions with a view to
   providing quality services.

■ Strategy 3: To review the existing mental health legislation of The Gambia in line
   with the international human rights standards.

■ Strategy 4: To raise awareness and reduce negative perceptions about those
   suffering from mental and substance abuse disorders through the use of advocacy
   and Information, Education and Communication (IEC) strategies.

■ Strategy 5: To improve the availability, distribution and use of cost-effective
   psychotropic medicines.

■ Strategy 6: To support the strengthening of the health management information
   system to adequately address mental health issues.

■ Strategy 7: To strengthen community involvement and participation in mental
   health care delivery.

■ Strategy 8: To create 3 in-patient mental health units and outpatient clinics
   integrated in the general hospitals.

■ Strategy 9: To improve treatment and human rights conditions in the Campama
   psychiatric unit until it is closed.

■ Strategy 10: To recruit and train a sufficient number of health workers at the
   specialised, community and primary health care levels in order for them to be able
   to provide appropriate quality mental health care at all levels.

■ Strategy 11: To train and support traditional healers in mental health.
■ Strategy 12: To regularly monitor and evaluate the mental heath policy and plan.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia


3. Strategies and related activities
Strategy 1: To strengthen the national mental health coordinating
unit at the Department of State for Health and Social Welfare.

RELATED ACTIVITIES
 Activity 1: Appoint a person to the post of national mental health coordinator at DOSH.

 Activity 2: Put into place the appropriate infrastructure to support the mental health
coordinating unit and the operationalisation of the coordinating committee.

 Activity 3: Create a multidisciplinary technical advisory committee to implement,
monitor and evaluate the policy and plan.

 Activity 4: Draft Terms of Reference (TOR) for the technical advisory committee,
including frequency of meetings.


TARGETS
►Appoint a mental health coordinator within six months.

►Establish a technical advisory committee for mental health services within six months.

►Make an infrastructure available to support the work of the mental health coordinating
unit within one year.


INDICATORS
 National mental health coordinator appointed.

 Clearly defined roles and functions of the coordinator available.

 Technical advisory committee in place and functioning with TOR.

 Allocation and availability of budget and resources (secretary, computer, internet
access).




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                            Republic of the Gambia

Strategy 2: To mobilize resources for mental health interventions
with a view to providing quality services.


RELATED ACTIVITIES
 Activity 1: Secure funding from government and other donors to fund the policy and
strategic plan, and open a bank account.

 Activity 2: Keep foundations and bi-laterals regularly informed of progress through
brief written updates and courtesy visits and meetings.

 Activity 3: Prepare at least five grant applications over the next five years.


TARGETS
► Clearly define and make available an annual budget for mental health (including
sources of funding) within one year.


INDICATORS
 An existing budget for mental health will be available for each year of the plan.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                           Republic of the Gambia

Strategy 3: To review the existing mental health legislation of The
Gambia in line with the international human rights standards.

RELATED ACTIVITIES
 Activity 1: Conduct an analysis of the strengths and weaknesses of the existing mental
health legislation.

 Activity 2: Prepare drafts of the new mental health legislation.

 Activity 3: Circulate successive drafts to stakeholders for comments and revise
accordingly.

 Activity 4: Conduct a workshop/workshops with stakeholders in order to achieve
consensus, finalize the draft legislation and prepare an implementation plan for the
legislation.

 Activity 5: Submit the new mental health legislation for cabinet and national assembly
for approval.

 Activity 6: Draft regulations to accompany the legislation.

 Activity 7: Set up independent review mechanisms to monitor involuntary admission,
treatment, and complaints and human rights conditions in facilities.

 Activity 8: Conduct training of all relevant groups in the implementation of the new
law.


TARGETS
► Draft a new law within two years.

► Implement new mental health legislation within five years.


INDICATORS
 A new mental health law in line with human rights standards is in place.

 An independent monitoring body is established and is functional.

 Complaints procedures are utilized.




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                  The Gambia Mental Health Strategic Plan 2007-2012
                                                        Republic of the Gambia

Strategy 4: To raise awareness and reduce negative perceptions
about those suffering from mental and substance abuse disorders
through the use of advocacy and Information, Education and
Communication (IEC) strategies.

RELATED ACTIVITIES
 Activity 1: Identify misconceptions, common fears, stigmatization and negative
attitudes towards people with mental disorders.

 Activity 2: Develop identified problems into messages and strategies via meetings with
the mental health coordinating unit, DOSH, user and family groups and the media.

 Activity 3: Engage in both print and electronic sensitization campaigns on an ongoing
basis.


TARGETS
► Put ongoing media campaigns (broadcasting, TV, radio, newspaper) in place,
developed nationwide each year.


INDICATORS
 Proportion of the population who recalled one or more of the key messages.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia

Strategy 5: To improve the availability, distribution and use of cost-
effective psychotropic medicines.

RELATED ACTIVITIES
 Activity 1: Review and update the current list of psychotropic medicines included in
the National Essential Drugs List.

 Activity 2: Revise recommended list of psychotropic medicines to be available in the
different health facilities and send for international expert review.

 Activity 3: Improve the distribution of psychotropic medicines to the different
facilities.

 Activity 4: Develop and put in place treatment protocols and guidelines for the use of
psychotropic medicines in each health facility where medicines will be made available.

 Activity 5: Put in place a stock monitoring system for psychotropic medicines in each
health facility where medicines will be made available.


TARGETS
► Implement national standards for mental health care (services and treatment) by Year
3.

► Make those medicines identified in the national essential drug list available in relevant
health facilities by Year 1.


INDICATORS
 Availability of guidelines and protocols for mental health treatment and services in all
health facilities.

 Percentage of patients with access to a constant supply of psychotropic medicines.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia

Strategy 6: To support the strengthening of the health management
information system to adequately address mental health issues.

RELATED ACTIVITIES
 Activity 1: Review the mental health component of the current HMIS.

 Activity 2: Establish a Multidisciplinary Task Team (MTT) responsible for designing
and implementing the mental health component of the HMIS.

 Activity 3: Organize a consultation of stakeholders in order to identify the key
indicators for the HMIS and a minimum mental health data set to be collected in each
health facility.

 Activity 4: Design and incorporate mental health information into the HMIS
(instruction / procedure manuals, data collection forms) for use in the different health
facilities.

 Activity 5: Pilot the tools in selected health facilities, to test feasibility and
implementation problems.

 Activity 6: Scale up the use of mental health HMIS at all level of delivery, including
the training of all staff involved.


TARGETS
► Record key information on all patients accessing mental health services (symptoms,
diagnosis, treatment, hospitalization, follow-up and rehabilitation activities) by Year 5.


INDICATORS
 A minimum dataset is collected and processed.

 The proportion of mental health facilities from which the government health
department receives data, per year.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia

Strategy 7: To strengthen community involvement and participation
in mental health care delivery.

RELATED ACTIVITIES
 Activity 1: Create local associations of psychosocial rehabilitation involving formal
health care providers, community leaders and traditional healers within each health
division.

 Activity 2: Organize meetings of each local association of psychosocial rehabilitation
in order to define modalities for work in the area of mental health at the primary health
care level.

 Activity 3: Create a national association of psychosocial rehabilitation with
representatives from local associations, with a clear mandate and TOR.

 Activity 4: Organize a minimum of one meeting a year of the national association of
psychosocial rehabilitation.


TARGETS
► Make a local association of psychosocial rehabilitation available in each division
within three years.

► Establish the national association within five years.


INDICATORS
 Each local association established and several meetings held.

 National association established and at least one meeting held.




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                         The Gambia Mental Health Strategic Plan 2007-2012
                                                                        Republic of the Gambia

Strategy 8: To create 3 in-patient mental health units and
outpatient clinics integrated in the general hospitals.1

RELATED ACTIVITIES
 Activity 1: Consult with hospital authorities and other stakeholders to discuss the
creation of mental heath units and outpatient clinics in three hospitals (Serekunda,
Farafenni, and Bansang).

 Activity 2: Identify an appropriate wing and set-up an inpatient mental health unit to
accommodate twelve patients in each of the three main general hospitals.

 Activity 3: Equip the mental health in-patient units with basic infrastructure and
psychotropic medicines.

 Activity 4: Deploy trained mental health workers to run the three in patient- units:
        Within the first year, per unit: one registered psychiatric nurse, five general
           nurses who have completed a one-week orientation and on-the-job training,
           and one medical doctor who has attended a mental health orientation
           workshop.
        Within the next five years, per unit: four trained registered psychiatric nurses
           (three for in-patient unit and one for outpatients), one psychiatrist and one
           clinical psychologist).

 Activity 5: Strengthen the outpatient department of the hospitals to provide mental
health services, including the provision of psychotropic medications and one general
nurse who has completed the orientation for the outpatient unit (eventually to be replaced
by a registered psychiatric nurse).

 Activity 6: Train other key hospital staff to manage people with mental disorders (at
least one general medical doctor and three nursing officers in charge (NO). See Strategy
10 - human resources and training).

 Activity 7: Quarterly supervision of inpatient and outpatient wards in each hospital by
qualified external mental health supervisors (University of the Gambia and mental health
coordinating unit).

TARGETS
► Create a concrete plan for setting up the units in the three general hospitals within two
months.

► Create one psychiatric in-patient unit and outpatient department integrated in one
general hospital, within one year.

► Create the remaining two in-patient units within five years.
1
    This strategy needs to be implemented together with Strategy 10 (Activities 1-5).


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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia

INDICATORS
 Number of units created.

 Number of trained mental health workers manning the unit.

 Quarterly visits to each of the hospitals undertaken.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                           Republic of the Gambia

Strategy 9: To improve treatment and human rights conditions in
the Campama psychiatric unit pending its closure.

RELATED ACTIVITIES
 Activity 1: Set up an independent visiting committee (composition includes
representatives of the UTG, medical and dental council, Ombudsman, Attorney General's
office, human rights commission) to assess the degree to which the unit meets human
rights standards on an annual basis and to make the findings publicly available until the
unit is closed.

 Activity 2: Discuss the results of the assessment with staff in the unit and train staff in
human rights.

 Activity 3: Put in place a mechanism to improve the conditions in the unit according to
assessment results and recommendations until its eventual closure.

 Activity 4: Conduct a qualitative community survey to understand the acceptability of
discharging long term in-patients into the community both before and after they have
been discharged in order to address the obstacles identified.

 Activity 5: Assess the level of disability, risk of relapse and home conditions of each
chronic patient in the Campama Unit.

 Activity 6: Discharge the least disabled back to their families and communities with the
appropriate monitoring and support from divisional community mental health nurses,
social workers and traditional healers who are part of the national mental health
traditional healers association.


TARGETS
► Discharge 20% of chronic patients (the least disabled and with family acceptance) into
their families within the first four years (with 10% discharged in the first two years).

► Improve on all standards relating to human rights in Campama unit.


INDICATORS
 Proportion of patients discharged from Campama unit.

 Proportion of successful discharges (e.g. no relapse and no readmission within six
months).

 Ratings on WHO human rights instrument.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                           Republic of the Gambia

Strategy 10: To recruit and train a sufficient number of health
workers at the specialized, community and primary health care
levels.

RELATED ACTIVITIES
 Activity 1: Develop and adapt training materials, including for substance and alcohol
abuse, for health workers at all levels.

 Activity 1: Train mental health workers to run the in-patient units in the general
hospitals:
        Within the first year, per unit: one registered psychiatric nurse, five general
           nurses with four-weeks of orientation work and on-the-job training, and one
           medical doctor who has completed a mental health orientation workshop.

 Activity 3: Send twelve registered nurses for training in mental health abroad, to
eventually be deployed in the general hospitals as registered psychiatric nurses (three for
the in-patient unit and one for the outpatient department in each of the three hospitals).

 Activity 4: Send two doctors (trained in the Gambia) for training abroad as psychiatrists
to be deployed in general hospitals.

 Activity 5: Train fifteen general nurses in mental health and three nursing officers
through orientation courses (duration of sessions: 4 weeks) to be deployed to the general
hospitals whiles the registered nurses in psychiatry are being trained.

 Activity 6: Train six social workers in mental health abroad in a five-year period, to be
deployed to divisional health teams (DHT).

 Activity 7: Train the focal point at each DHT (while the CMHN are being trained
abroad) and five other personnel (one doctor, three nurses, one public health officer) from
each major and minor health centre.

 Activity 8: Refresher training abroad for psychiatric nurses in the country every five
years.

 Activity 9: Train seven health education officers in mental health promotion.

 Activity 10: Train security officers (fifty officers - ten from each category), ten health
journalists, and legal practitioners (six - from different divisions).

 Activity 11: Train two teachers in each of the selected ten schools to identify and refer
mental health problems, including problems related to substances and alcohol abuse
issues.

 Activity 12: One study tour or conference for at least two mental health providers per
year.


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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia

TARGETS
► Recruit and train twelve nurses and two doctors as psychiatric nurses and psychiatrists
respectively within 5 years.

► Have at least one medical officer per hospital and five trained nurses per hospital
undergo local WHO orientation in mental health training within one year.

► Develop training materials for each health system level in the first year.

► Train three health personnel in mental health from 50% of health facilities by Year 3
and 100% by Year 5.


INDICATORS
 Number of specialized mental health workers recruited and trained within five years.

 Number of health personnel from health facilities trained.

 Number of non-health personnel trained.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                          Republic of the Gambia

Strategy 11: To train and support traditional healers in mental
health

RELATED ACTIVITIES
 Activity 1: Train all volunteer traditional healers to identify and treat people with
mental disorders.

 Activity 2: Hold teaching and exchange sessions on mental health diagnosis and
treatment in traditional medicine (organized by traditional healers for primary health care
workers).

 Activity 3: Set up a referral and support system for traditional healers when dealing
with people with mental disorders.


TARGETS
► Train at least 50% of the traditional healers identified in the country in basic mental
health knowledge and skills, to involve them in active collaboration with local formal
health services for the care of people with mental disorders within five years.


INDICATORS
 Proportion of trained traditional healers.

 Proportion of traditional healers actively collaborating with local formal health
services.




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                   The Gambia Mental Health Strategic Plan 2007-2012
                                                            Republic of the Gambia

Strategy 12: To monitor and evaluate the mental heath policy and
plan.

RELATED ACTIVITIES
 Activity 1: Clarify the purpose and scope of the monitoring and evaluation.

 Activity 2: Regular monitoring and evaluation of mental health activities by the
technical advisory committee.

 Activity 3: Prepare an operational plan for the evaluation.

 Activity 4: Set up and support evaluation visits by community leaders to enterprises/
associations for follow-up, twice a year.

 Activity 5: Evaluate the impact of the collaboration with traditional healers on the
mental health outcomes in the community.

 Activity 6: Prepare quarterly reports and a report at end of five years of the plan.


TARGETS
► Monitor all activities and outputs, and produce a short quarterly and yearly report on
each.

► Produce a five-year report on the evaluation of the mental health policy and plan.


INDICATORS
 Quarterly and yearly reports on all the activities will be in place/available.

 A five-year report assessing the degree to which targets were met for each of the
strategies and the policy objectives.




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      The Gambia Mental Health Strategic Plan 2007-2012
                                     Republic of the Gambia




PLANNING TABLES




                                                              19
                                                                          The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                     Republic of the Gambia

Strategy 1: To strengthen the national mental health coordinating unit at the Department of State for
Health                          and                          Social                          Welfare.

TARGETS                                                                             INDICATORS
►Appoint a mental health coordinator within six months.                              National mental health coordinator appointed.
►Establish a technical advisory committee for mental health services                 Clearly defined roles and functions of the coordinator available.
within six months.                                                                   Technical advisory committee in place and functioning with TOR.
►Make an infrastructure available to support the work of the mental                  Allocation and availability of budget and resources (secretary,
health coordinating unit within one year.                                           computer, internet access).


                                                                                              Timeframe for implementation
                                                                                                                                          Cost
    Related Activities (Strategy 1)                                                                       (years)
                                                                                                                                         (US$)
                                                                                                 1      2       3      4      5
                                                                                                                                      Government
    1. Appoint a person to the post of national mental health coordinator at DOSH               X
                                                                                                                                    approved salary2
    2. Put into place the appropriate infrastructure to support the mental health
                                                                                                X       X       X      X      X         125,000
    coordinating unit and the operationalisation of the coordinating committee
    3. Create a multidisciplinary technical advisory committee to implement, monitor
                                                                                                X       X       X      X      X          6,000
    and evaluate the policy and plan
    4. Draft Terms of Reference (TOR) for the technical advisory committee, including
                                                                                                X                                        1,800
    frequency of meetings

                                                                                              TOTAL COST (Strategy 1)                  132,800




2
    Full cost of salary to be covered by the government.


                                                                                                                                                       20
                                                                       The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                              Republic of the Gambia

Strategy 2: To mobilize resources for mental health interventions with a view to providing quality
services.

TARGETS                                                                    INDICATORS
► Clearly define and make available an annual budget for mental             An existing budget for mental health will be available for each year
health (including sources of funding) within one year.                     of the plan.


                                                                                      Timeframe for implementation
                                                                                                                                    Cost
Related Activities (Strategy 2)                                                                   (years)
                                                                                                                                   (US$)
                                                                                         1        2       3      4      5
1. Secure funding from the government to fund the policy and strategic plan, and                                             Create a new bank
                                                                                         X
open a bank account                                                                                                               account
2. Keep foundations and bi-laterals regularly informed of progress through brief
                                                                                         X       X        X      X     X           21,000
written updates and courtesy visits and meetings
3. Prepare at least five grant applications over the next five years                     X       X        X      X     X            4,500

                                                                                      TOTAL COST (Strategy 2)                     25,500




                                                                                                                                              21
                                                                    The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                            Republic of the Gambia

Strategy 3: To review the existing mental health legislation of The Gambia in line with the
international human rights standards.

TARGETS                                                                   INDICATORS
► Draft a new law within two years.                                        A new mental health law in line with human rights standards is in
► Implement new mental health legislation within five years.              place.
                                                                           An independent monitoring body is established and is functional.
                                                                           Complaints procedures are utilized.


                                                                                          Timeframe for implementation
Related Activities (Strategy 3)                                                                      (years)                  Cost (US$)
                                                                                          1      2       3    4      5
1. Conduct an analysis of the strengths and weaknesses of the existing mental health
                                                                                          X                                     20,000
legislation
2. Prepare drafts of the new mental health legislation                                    X                                     21,600
3. Circulate successive drafts to stakeholders for comments and revise accordingly               X      X                       5,000
4. Conduct a workshop/workshops with stakeholders in order to achieve consensus,
                                                                                                        X                        4,000
finalize the draft legislation, and prepare an implementation plan for the legislation
5. Submit the new mental health legislation to cabinet and the national assembly for
                                                                                                        X                        1,250
approval
6. Draft regulations to accompany the legislation                                                              X                 9,000
7. Set up independent review mechanisms to monitor involuntary admission,
                                                                                          X      X      X      X     X          36,000
treatment, complaints, and human rights conditions in facilities
8. Conduct training of all relevant groups in the implementation of the new law                  X      X      X     X          55,000

                                                                                         TOTAL COST (Strategy 3)               151,850




                                                                                                                                           22
                                                                    The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                               Republic of the Gambia


Strategy 4: To raise awareness and reduce negative perceptions about those suffering from mental and
substance abuse disorders through the use of advocacy and Information, Education and
Communication (IEC) strategies.

TARGETS                                                                    INDICATORS
► Put ongoing media campaigns (broadcasting, TV, radio,                     Proportion of the population who recalled one or more of the key
newspaper) in place, developed nationwide each year.                       messages.


                                                                                           Timeframe for implementation
                                                                                                                                     Cost
Related Activities (Strategy 4)                                                                       (years)
                                                                                                                                    (US$)
                                                                                           1       2       3        4     5
1. Identify misconceptions, common fears, stigmatization and negative attitudes towards
                                                                                                   X                                5,000
people with mental disorders
2. Develop identified problems into messages and strategies via meetings with mental
                                                                                                   X      X        X                4,000
health coordinating unit, DOSH, user and family groups, and the media
3. Engage in both print and electronic sensitization campaigns on an ongoing basis                 X      X        X      X         19,750

                                                                                          TOTAL COST (Strategy 4)                  28,750




                                                                                                                                             23
                                                                        The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                  Republic of the Gambia

Strategy 5: To improve the availability, distribution and use of cost-effective psychotropic medicines.

TARGETS                                                                       INDICATORS
► Implement national standards for mental health care (services and            Availability of guidelines and protocols for mental health treatment
treatment) by Year 3.                                                         and services in all health facilities.
► Make those medicines identified in the national essential drug list          Percentage of patients with access to a constant supply of
available in relevant health facilities by Year 1.                            psychotropic medicines.


                                                                                              Timeframe for implementation
                                                                                                                                        Cost
 Related Activities (Strategy 5)                                                                         (years)
                                                                                                                                       (US$)
                                                                                              1       2       3       4      5
 1. Review and update the current list of psychotropic medicines included in the
                                                                                              X                                         6,000
 National Essential Drugs List
 2. Revise the recommended list of psychotropic medicines to be available in the
                                                                                                      X                                 9,900
 different health facilities and send for international expert review
 3. Improve the distribution of psychotropic medicines to the different facilities            X       X       X      X      X         200,000
 4. Develop and put in place treatment protocols and guidelines for the use of
                                                                                              X       X       X      X      X          49,000
 psychotropic medicines in each health facility where medicines will be made available
 5. Put in place a stock monitoring system for psychotropic medicines in each health
                                                                                              X       X       X      X      X          12,500
 facility where medicines will be made available

                                                                                            TOTAL COST (Strategy 5)                  313,900




                                                                                                                                                 24
                                                                      The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                Republic of the Gambia

Strategy 6: To support the strengthening of the health management information system to adequately
address mental health issues.

TARGETS                                                                      INDICATORS
► Record key information on all patients accessing mental health              A minimum dataset is collected and processed.
services (symptoms, diagnosis, treatment, hospitalization, follow-up          The proportion of mental health facilities from which the
and rehabilitation activities) by Year 5.                                    government health department receives data, per year.



                                                                                             Timeframe for implementation
                                                                                                                                     Cost
Related Activities (Strategy 6)                                                                         (years)
                                                                                                                                    (US$)
                                                                                             1        2     3       4      5
1. Review mental health component of the current HMIS                                                 X     X                        6,000
2. Establish Multidisciplinary Team (MTT) responsible for designing & implementing
                                                                                             X        X     X      X      X          3,000
the mental health component of the HMIS
3. Organize a consultation of stakeholders in order to identify the key indicators for the
                                                                                                            X                        6,000
HMIS and a minimum mental health data set to be collected in each health facility.
4. Design and incorporate mental health information into the HMIS (instruction/
                                                                                                      X     X      X      X         15,000
procedure manuals, data collection forms) for use in different health facilities
5. Pilot the tools in selected health facilities to test feasibility and implementation
                                                                                                      X     X      X      X         24,000
problems
6. Scale up the use of mental health HMIS at all levels of delivery, including the
                                                                                                            X      X      X         34,500
training of all staff involved

                                                                                                 TOTAL COST (Strategy 6)           88,500




                                                                                                                                             25
                                                                     The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                Republic of the Gambia

Strategy 7: To strengthen community involvement and participation in mental health care delivery.

TARGETS                                                                    INDICATORS
► Make a local association of psychosocial rehabilitation available in      Each local association established and several meetings held.
each division within three years.                                           National association established and at least one meeting held.
► Establish the national association within five years.


                                                                                            Timeframe for implementation
                                                                                                                                      Cost
Related Activities (Strategy 7)                                                                        (years)
                                                                                                                                     (US$)
                                                                                            1      2        3       4     5
1. Create local associations of psychosocial rehabilitation involving formal health care
                                                                                            X      X       X       X                 6,000
providers, community leaders and traditional healers within each health division
2. Organize meetings of each local association of psychosocial rehabilitation in order
to define modalities for work in the area of mental health at the primary health care       X      X       X       X                 30,000
level
3. Create a national association of psychosocial rehabilitation with representatives
                                                                                                           X                         3,000
from local associations, with a clear mandate and TOR
4. Organize a minimum of one meeting a year of the national association of
                                                                                                           X       X                 40,000
psychosocial rehabilitation
                                                                                           TOTAL COST (Strategy 7)                  79,000




                                                                                                                                               26
                                                                               The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                          Republic of the Gambia

Strategy 8: To create 3 in-patient mental health units and outpatient clinics integrated in the general
hospitals.3

TARGETS                                                                                 INDICATORS
► Create a concrete plan for setting up the units in the three general                   Number of units created.
hospitals within two months.                                                             Number of trained mental health workers manning the unit.
► Create one psychiatric in-patient unit and outpatient department                       Quarterly visits to each of the hospitals undertaken.
integrated in one general hospital, within one year.
► Create the remaining two in-patient units within five years.




3
    This strategy needs to be implemented together with Strategy 10 (Activities 1-5).


                                                                                                                                                      27
                                                                      The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                           Republic of the Gambia

                                                                                         Timeframe for implementation
                                                                                                                                Cost
Related Activities (Strategy 8)                                                                     (years)
                                                                                                                               (US$)
                                                                                         1      2      3     4     5
1. Consult with hospital authorities and other stakeholders to discuss the creation of
mental heath units and outpatient clinics in three hospitals (Serekunda, Farafenni,      X      X      X                       3,825
and Bansang)
2. Identify an appropriate wing and to set up an in-patient mental health unit to
                                                                                         X                                      NIL
accommodate twelve patients in each of the three main general hospitals
3. Equip the mental health in-patient units with basic infrastructure and psychotropic
                                                                                         X      X      X     X     X          360,000
medicines
4. Deploy trained mental health workers to run the three in-patient units.                                                     3,000
   Within the first year, per unit: one registered psychiatric nurse, five general
   nurses who have completed a one-week orientation and on-the-job training, and
   one medical doctor who has attended a mental health orientation workshop                     X
   Within the next five years, per unit: four trained registered psychiatric nurses
   (three for the in-patient unit and one for outpatients), one psychiatrist and one                                      (future salary to
   clinical psychologist                                                                                                    be covered by
                                                                                                                               DOSH)
                                                                                         Timeframe for implementation
                                                                                                                                Cost
Related Activities (Strategy 8)                                                                     (years)
                                                                                                                               (US$)
                                                                                         1      2     3      4      5
5. Strengthen the outpatient department of the hospitals to provide mental health
services, including the provision of psychotropic medications and one general nurse
                                                                                         X      X      X     X     X          10,000
who has completed the orientation for the outpatient unit (eventually to be replaced
with a registered psychiatric nurse)
6. Train key hospital staff to manage people with mental disorders (at least one
general medical doctor and three nursing officers in charge (NO). See Strategy 10 -      X             X                       6,000
human resources and training)
7. Quarterly supervision of inpatient and outpatient wards in each hospital by
qualified external mental health supervisors (University of the Gambia and the           X      X      X     X     X           5,000
mental health coordinating unit)



                                                                                                                                          28
                                                                                  The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                               Republic of the Gambia

                                                                                                        TOTAL COST (Strategy 8)                 387,825
                                                                                                        Cost of training psychiatrists and
                                                                                                        psychiatric nurses                       797,000
                                                                                                        (see Strategy 10, Activities 1-5)

                                                                                                        TOTAL COST (Strategy 8)
                                                                                                        including cost of training4            1,184,825




4
    If funded as an independent strategy, the cost of the strategy will need to include the training of mental health staff.


                                                                                                                                                           29
                                                                       The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                               Republic of the Gambia

Strategy 9: To improve treatment and human rights conditions in the Campama psychiatric unit
pending its closure.

TARGETS                                                                       INDICATORS
► Discharge 20% of chronic patients (the least disabled and with               Proportion of patients discharged from Campama unit.
family acceptance) into their families within the first four years (with       Proportion of successful discharges (e.g. no relapse and no
10% discharged in the first two years).                                       readmission within six months).
► Improve on all standards relating to human rights in Campama                 Ratings on WHO human rights instrument.
unit.

                                                                                              Timeframe for implementation
                                                                                                         (years)                   Cost
  Related Activities (Strategy 9)
                                                                                                                                  (US$)
                                                                                              1     2      3      4      5
  1. Set up an independent visiting committee (composition includes representatives of
  UTG, medical and dental council, Ombudsman, Attorney General's office, Human
  rights commission) to assess the degree to which the unit meets human rights                X     X      X      X      X
  standards on an annual basis and make the findings publicly available until the unit is                                         21,600
  closed
  2. Discuss the results of the assessment with staff in the unit and train staff in human
                                                                                                    X      X      X                2,000
  rights
  3. Put in place a mechanism to improve the conditions in the unit according to
                                                                                                    X      X      X               11,000
  assessment results and recommendations until its eventual closure
  4. Conduct a qualitative community survey to understand the acceptability of
  discharging long term in-patients into the community both before and after they have              X                              5,000
  been discharged in order to address the obstacles identified
  5. Assess the level of disability, risk of relapse and home conditions of each chronic
                                                                                                    X      X      X      X         4,000
  patient in the Campama Unit
  6. Discharge the least disabled back to their families and communities with the
  appropriate monitoring and support from divisional community mental health nurses,
                                                                                                    X      X      X      X         8,000
  social workers and traditional healers who are part of the national mental health
  traditional healers association

                                                                                             TOTAL COST (Strategy 9)             51,600


                                                                                                                                           30
                                                                           The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                   Republic of the Gambia

Strategy 10: To recruit and train a sufficient number of health workers at the specialized, community
and primary health care levels.

TARGETS                                                                          INDICATORS
► Recruit and train twelve nurses and two doctors as psychiatric                  Number of specialized mental health workers recruited and trained
nurses and psychiatrists respectively within 5 years.                            within five years.
► Have at least one medical officer per hospital and five trained                 Number of health personnel from health facilities trained.
nurses per hospital undergo local WHO orientation in mental health
                                                                                  Number of non-health personnel trained.
training within one year.
► Develop training materials for each health system level in the first
year.
► Train three health personnel in mental health from 50% of health
facilities by Year 3 and 100% by Year 5.


                                                                                               Timeframe for implementation
                                                                                                                                        Cost
    Related Activities (Strategy 10)                                                                      (years)
                                                                                                                                       (US$)
                                                                                               1      2       3      4      5
    1. Develop and adapt training materials, including for substance and alcohol abuse,
                                                                                               X      X      X                         9,000
    for health workers at all levels
    2. Train mental health workers to run the three in-patient units in general hospitals.
         Within the first year, per unit: one registered psychiatric nurse, five general      X      X                                6,000
        nurses with four-weeks of orientation work and on-the-job training, and one
        medical doctor who has completed a mental health orientation workshop
    3. Send twelve registered nurses for training in mental health abroad, to eventually
    be deployed in the general hospitals as registered psychiatric nurses (three for the in-   X      X      X                        420,000
    patient unit and one for the outpatient department in each of the three hospitals)
    4. Send two doctors (trained in the Gambia) for training abroad as psychiatrists to be
    deployed in general hospitals5                                                             X      X                               350,000


5
    Cost estimates based on training in Nigeria.


                                                                                                                                                 31
                                                                      The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                             Republic of the Gambia

                                                                                           Timeframe for implementation
                                                                                                                                 Cost
Related Activities (Strategy 10)                                                                      (years)
                                                                                                                                (US$)
                                                                                           1      2     3      4      5
5. Train fifteen general nurses in mental health and three nursing officers through
orientation courses (duration of sessions: 4 weeks) to be deployed to the general          X            X            X          12,000
hospitals whiles the registered nurses in psychiatry are being trained
6. Train six social workers in mental health abroad, in a five-year period, to be
                                                                                                  X                             45,000
deployed to divisional health teams (DHT)
7. Train the focal point at each DHT (while the CMHN are being trained abroad) and
five other personnel (one doctor, three nurses, one public health officer) from each       X      X     X                        8,460
major and minor health centre
8. Refresher training abroad for psychiatric nurses in the country every five years                     X                       10,000
9. Train seven health education officers in mental health promotion                        X            X                        5,000
10. Train security officers (fifty officers - ten from each category), ten health
                                                                                           X            X                       10,000
journalists, and legal practitioners (six - from different divisions)
11. Train two teachers in each of the selected ten schools to identify and refer mental
                                                                                           X                  X                  4,000
health problems, including problems related to substances and alcohol abuse issues
12. One study tour or conference for at least 2 mental health providers per year                              X      X           6,000

                                                                                          TOTAL COST (Strategy 10)            893,920




                                                                                                                                         32
                                                                              The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                             Republic of the Gambia

Strategy 11: To train and support traditional healers in mental health

TARGETS                                                                              INDICATORS
► Train at least 50% of the traditional healers identified in the                     Proportion of trained traditional healers.
country in basic mental health knowledge and skills, to involve them                  Proportion of traditional healers actively collaborating with local
in active collaboration with local formal health services for the care of            formal health services.
people with mental disorders within five years.


                                                                                                   Timeframe for implementation
                                                                                                                                                       Cost
    Related Activities (Strategy 11)                                                                          (years)
                                                                                                                                                      (US$)
                                                                                                  1          2        3        4        5
    1. Train all volunteer traditional healers to identify and treat people with mental
                                                                                                  X         X                                        25,000
    disorders
    2. Hold teaching and exchange sessions on mental health diagnosis and treatment
    in traditional medicine (organized by traditional healers for primary health care                                 X        X                     45,000
    workers)
    3. Set up a referral and support system for traditional healers when dealing with
                                                                                                            X         X        X        X            70,000
    people with mental disorders

                                                                                               TOTAL COST (Strategy 11)                            140,000
                                                                                               Cost of training (see Strategy 10,
                                                                                                                                                      8,460
                                                                                               Activity 7)

                                                                                               Cost of distribution of medications
                                                                                                                                                    200,000
                                                                                               (see Strategy 5, Activity 3)6

                                                                                               TOTAL COST (Strategy 11)
                                                                                               including training, and distribution of             348,460
                                                                                               medications

6
  If funded as an independent strategy, the cost of the strategy will need to include training of DHT focal points and some health centre personnel, as well as
funds towards supply of medicines.


                                                                                                                                                                  33
                                                                        The Gambia Mental Health Strategic Plan 2007-2012
                                                                                                                Republic of the Gambia

Strategy 12: To monitor and evaluate the mental heath policy and plan.

TARGETS                                                                       INDICATORS
► Monitor all activities and outputs, and produce a short quarterly            Quarterly and yearly reports on all the activities will be in
and yearly report on each.                                                    place/available.
► Produce a five-year report on the evaluation of the mental health            A five-year report assessing the degree to which targets were met
policy and plan.                                                              for each of the strategies and the policy objectives

                                                                                           Timeframe for implementation
                                                                                                                                     Cost
 Related Activities (Strategy 12)                                                                     (years
                                                                                                                                    (US$)
                                                                                            1      2       3      4      5
 1. Clarify the purpose and scope of the monitoring and evaluation                          X                                       2,000
 2. Regular monitoring and evaluation of mental health activities by the technical
                                                                                            X      X      X      X       X          10,000
 advisory committee
 3. Prepare an operational plan for the evaluation                                          X                                       2,000
 4. Set up and support evaluation visits by community leaders to enterprises/
                                                                                                   X      X      X                  6,000
 associations for follow-up, twice a year
 5. Evaluate the impact of the collaboration with traditional healers on the mental
                                                                                                   X                     X          7,000
 health outcomes in the community
 6. Prepare quarterly reports and a report at end of five years of the plan                 X      X      X      X       X          5,000

                                                                                          TOTAL COST (Strategy 12)                 32,000




                                                                                                                                              34
                                                           The Gambia Mental Health Strategic Plan 2007-2012
                                                                                            Republic of the Gambia

SUMMARY TABLE
Table: Summary Cost of Implementing the Mental Health Strategic Plan 2007-2012

                                                                                                             Total
                                 Year1           Year2         Year 3            Year 4   Year 5
                                                                                                             (US$)
Strategy 1                       111,000          7,200          4,800            5,600    4,200             132,800
Strategy 2                        5,100           5,100          5,100            5,100    5,100              25,500
Strategy 3                       48,800          30,200         22,450           27,700   18,700             147,850
Strategy 4                          -            12,500          5,750            5,750    4,750              28,750
Strategy 5                       59,000          89,400         57,750           47,250   60,500             313,900
Strategy 6                         600           19,600         27,600           20,350   20,350              88,500
Strategy 7                        2,900           7,350         36,650           32,100      -                79,000
Strategy 8                       107,275         92,275         82,275           63,000   43,000             387,825
Strategy 9                        4,320          16,920         11,920           11,120    7,320              51,600
Strategy 10                      321,100        382,000        178,820            5,000    7,000             893,920
Strategy 11                      10,000          25,000         30,000           45,000   30,000             140,000
Strategy 12                       7,000           8,500          5,000            5,000    6,500              32,000
TOTAL COST
(Strategic Plan 2007-2012)
                                677,095         696,045        468,115       272,970      207,420          2,321,645




                                                                                                                       35
                                                           The Gambia Mental Health Strategic Plan 2007-2012
                                                                                             Republic of the Gambia

SUMMARY Graph

     (US$)

     700,000

     600,000

     500,000

     400,000

     300,000

     200,000

     100,000

             0
             Year1                  Year2                    Year 3                 Year 4                    Year 5




                     Strategy 1     Strategy 2      Strategy 3        Strategy 4    Strategy 5       Strategy 6
                     Strategy 7     Strategy 8      Strategy 9        Strategy 10   Strategy 11      Strategy 12

Graph: Summary Cost of Implementing the Mental Health Strategic Plan 2007-2012




                                                                                                                       36
                           The Gambia Mental Health Strategic Plan 2007-2012
                                                                     Republic of the Gambia


References
 WHO Mental Health Policy and Service Guidance Package. World Health Organization: Geneva:
           ►   The Mental Health Context (2003)
           ►   Mental Health Policy, Plans and Programmes (Updated Version 2005)
           ►   Mental Health Financing (2003)
           ►   Mental Health Legislation and Human Rights (2003)
           ►   Advocacy for Mental Health (2003)
           ►   Organization of Services for Mental Health (2003)
           ►   Quality Improvement for Mental Health (2003)
           ►   Planning and Budgeting to Delivery Services for Mental Health (2003)
           ►   Improving Access and Use of Psychotropic Medicines (2005)
           ►   Mental Health Information Systems (2005)
           ►   Human Resources and Training for Mental Health (2005)
           ►   Child and Adolescent Mental Health (2005)
           ►   Research and Evaluation of Mental Health Policy and Services (to be published, 2006)
           ►   Workplace Mental Health Policies and Programmes (in press).
           These modules are available in hard copy and electronic format:
           http://www.who.int/mental_health/policy/en/

 WHO Resource Book on Mental Health, Human Rights and Legislation. Stop exclusion, dare to
  care. World Health Organization: Geneva, 2005. url:
  http://www.who.int/mental_health/policy/who_rb_mnh_hr_leg_FINAL_11_07_05.pdf

 WHO Mental Health Atlas 2005 (revised edition). World Health Organization: Geneva, 2005.

 WHO (2001) World Health Report 2001. Mental Health: New Understanding, New Hope. World
  Health Organization: Geneva. 169 pages. url: http://www.who.int/whr/2001/en/

 WHO-AIMS (World Health Organization Assessment Instrument for Mental Health Systems), version
  2.2. World Health Organization: Geneva, 2005. url:
  http://www.who.int/mental_health/evidence/AIMS_WHO_2_2.pdf

 Report of the African commission: Purohit and Moore v Gambia. African Commission on Human
  and People's Rights. The Housing and ESC Rights Law Quarterly, vol.1, n°1, p 4-5;
  http://www.cohre.org/downloads/Quarterly_01.pdf




                                                                                                      37
The Gambia Mental Health Strategic Plan 2007-2012
                               Republic of the Gambia




   annexes




                                                        38
                         The Gambia Mental Health Strategic Plan 2007-2012
                                                               Republic of the Gambia


Annex 1
ACKNOWLEDGEMENTS
Review and comments provided by:
The Gambia National Mental Health Taskforce: Technical Committee
Dr.Lamin Sidibeh: Chairman
Mr. Bakary Sonko: Coordinator
Mr. Sutay M. Jawo: Vice-Chairman
Mr. Sarjo K. Jaiteh: Member
Mr. Sambujang Conteh: Member
Mr. Ebrima Bah: Member
Mr. Alfusainey Jara: Member
Mr. Lamin A K Touray Lawyer: Member
Mr. .Musa Sanyang: Member
Mr. Omar Jammeh: Member
Dr Mariatou Jallow: Director of Health Services, The Gambia.

WHO HQ, Geneva
Dr Michelle Funk, Coordinator, Mental health policy and Service Development,
Dr Edwige Faydi, Technical Officer, Mental health policy and Service Development,
Dr Natalie Drew, Technical Officer, Mental health policy and Service Development,

WHO Regional Office for Africa
Dr Agossou, Regional Advisor for Mental Health,

WHO Country Office The Gambia
Dr Nestor Shivute, WHO Representative
Mr. George Williams, WHO Assistant Public Information
Mr Momodou Gassama, WHO National Information Officer

WHO network experts for Policy and Service Development
Dr Dixon Chibanda, WHO expert for Mental Health Policy, legislation and service development,
Zimbabwe,
Dr Sonia Chehil, WHO expert for Mental Health Policy and Service development, Canada.




                                                                                          39
                      The Gambia Mental Health Strategic Plan 2007-2012
                                                            Republic of the Gambia


National Mental Health Taskforce Members
NAME                  DEPT. / INSTITUTION / AGENCY
Fanny Walliams        National Drug Squad Police Headquarters
PA Modou Faal         Point Newspaper/Association of Health Journalists
Cecilia Bass          The Point Newspaper
FR Pascal Mendy       Catholic Relief Mission – Banjul
Ruth Bowen            Methodist Mission
Dr. Ahmed Shoukry     Gambia National Army
Maram Bobb            School of Nursing and Midwifery
Gibril Sumbundu       Peace Corps – The Gambia
Fanta. B. Sisay       Dept of Social Welfare
Jorgoman H. Sowe      Dept of Social Welfare
Mam Marie Jagne       PNO – RVH
Ann Marie Mendy       Campama – RVH
Saikou Janneh         Director of Planning and Information DOSH
Boubacarr Cham        Co-director City Limits Radio
Sainey E.M. Cham      Divisional Health Administrator DHT NB West (Essau)
Alhaji M.M Jallow     Chairman of International Organization of Good Templers Gambia
Ibrahim Bun Sanneh    Coordinator, National Drug Control Council
Lamin Sidibeh         Bakau Wasulung Mental Care
Momodou Gassama       WHO
Sambujang Conteh      Raid – Gambia
Thomas A.B. King      Nurses and Midwife Council
Michelle N. Sarr      Nurses and Midwife Council
Ebrima B. Dampha      DHT – Western – Kanifing
Muna Manneh           Tarud – Gunjur
K.O. Jaiteh           Dept. of State for Health
Sarjo K. Jaiteh       Child – Welfare – Police Head Quarters
Bakary Sonko          Community Mental Health Team
Omar Jammeh           Community Mental Health Team
Sutay M. Jawo         Department of Youths and Sports
Ebrima BAH            Campama Psychiatric Unit
George Williams       W.H.O
Bakary Darboe         Department of State for Health
Dr. Esenbegdo         Chief Medical Director RVTH
Mr. Jobe              Daily Observer News Papers
Sulayman Makalo       Independent News Paper
Dr. Lowe              Head-Office of the Ombudsman
Fanta Jatta-Sowe      Health Education Unit
Mr. Sillah            Traditional Medicine Programme-D.OS.H
Mr. Ngum              Public Relation Officer-RVTH
Mr. Sisoho (lawyer)   Depart of Justice
Sana Jawara           Divisional Health Officer-Central River Division



                                                                                       40
                            The Gambia Mental Health Strategic Plan 2007-2012
                                                                 Republic of the Gambia


MEMBERS OF THE TECHNICAL COMMITTEE FROM THE TASKFORCE LIST
Dr.Lamin Sidibeh       Chairman
Mr. Bakary Sonko       Coordinator
Mr.Sutay M. Jawo       Vice Chairman
Mr. Sarjo K. Jaiteh    Member
Mr.Sambujang Conteh    Member
Mr.Ebrima Bah          Member
Mr. Alfusainey Jara    Member
Mr.Lamin Touray Lawyer Member
Mr.Musa Sanyang        Secretary
Mr Omar Jammeh         Member

REGRETS
HEAD                        Voluntary Service Overseas
Divisional Health Officer   Divisional Health Team-Bansang`
Divisional Health Officer   Divisional Health Team-Mansa Konko
Lawyer Sisoho               Depart of Justice
Secretary                   National Assembly




                                                                                          41
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